Inflammatory Bowel Disease Center | Treatment & Medications

Learn about medication and treatment options for pediatric ulcerative colitis. Learn what happens when a medication is ineffective or resistant, as well as information about the medication safety and side effects.

Summary points 

• The first goal of treatment for ulcerative colitis (UC) is to get the patient’s symptoms under control as quickly as possible.

• When patients are first diagnosed and their disease is active, strong medications, called “induction agents,” are used to control inflammation. For patients with a more mild form of the disease, aminosalicylate medications may be used. For patients with moderate or more severe disease, steroids such as prednisone may be used. Prednisone begins to work quickly, but is not typically used as a long-term medication due to its side effects.

• Once induction agents take effect, other medications, called “maintenance medications,” are introduced to keep the disease under control. These agents generally have fewer long-term side effects. Maintenance medications for UC include the aminosalicylates, such as mesalamine and sulfasalazine. For patients that experience flares while using these medications, an immune modulator drug can be used, such as 6-mercaptopurine (6-MP) or azathioprine.

• At times, the inflammation may no longer respond to maintenance medications and more potent medicines, called “rescue medications,” are needed to get inflammation under control again. Prednisone may be used as a rescue medication.

• If a patient’s symptoms are not improving, another medication may be needed. These alternative medications include infliximab, cyclosporine or tacrolimus.

• If medical therapy is consistently ineffective in controlling inflammation, patients and their physicians may discuss surgical options.

• Patients with UC should be seen regularly by their physicians. Routine appointments provide the opportunity to assess disease activity and monitor for side effect of medications.